| NPI | 1740774306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA 20A17792) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA OP61639223) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2026-07-02 |